The following article is a part of conference coverage from the American Psychiatric Nurses Association (APNA) 34th Annual Conference, held online from September 30 to October 4, 2020. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading nurses in psychiatry. Check back for more from APNA 2020.

 

An Aggression Prevention Team (APTeam) has been found to be an effective de-escalation approach for individuals exhibiting escalating or violent behavior toward healthcare workers, according to a presentation at the 2020 meeting of the American Psychiatric Nurses Association (APNA) held online from September 30 to October 4, 2020.

This rapid response team was created at a children’s hospital that experienced an increase of 18% in its emergency department mental health census in the previous year. Because the number of behavioral alerts and consequent employee injuries was also increasing, an APTeam consisting of core staff members was assembled and trained to intervene early and de-escalate the situation. Members of the APTeam included the in-house nursing supervisor, bedside registered nurse, resident physician, psychiatrist, and mental health team member. The number of calls to the APTeam were compared with behavioral alerts, and data were captured on whether the situation was resolved by the arrival of the APTeam.

Between September 2019 and July 2020, 49 behavioral events occurred without intervention of the APTeam. The APTeam was called for 39 events of which 34 resulted in successful de-escalation; 5 were not successfully attenuated and were eventually recorded as behavioral events due to escalation. In July 2020, 16 staff members sustained injury, which represents a decrease from previous years; no serious injuries were involved.


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The authors concluded that the APTeam concept was successful and beneficial to both staff and individuals under care, with value added in “identifying escalating behaviors and addressing with early intervention.” The authors state the need for ongoing education, mock events, and data transparency to other members of the staff.

Reference

Fulcher KR, Andam-Mejia R, Bollinger, E, et al. Aggression Prevention Team: creating a rapid response team for mental health patients. Presented at: APNA 34th Annual Conference; September 30-October 4, 2020. Poster 70.